Stigma and global mental health: Association between country-level characteristics and mental illness stigma in 16 countries

Background: Mental illness stigma is implicated on macro, meso and micro levels and is believed to account for significant treatment gap for mental disorders worldwide. The objective of this analysis is to examine the association between country-level characteristics and mental illness stigma in 16 countries.

Methods: Estimates of percent prevalence of perceived stigma among individuals with mental disorders in 16 countries were obtained from the World Mental Health Surveys (Alonso et al., 2008). Estimates of country indicators were obtained from the United Nations Development Program (UNDP). The following variables were examined: Human Development Index (HDI) rankings (2010), Internet Users/100 (2008), and Homicide Rate/100,000 (2008). The HDI variable is a composite measure of human development that reflects 3 country dimensions (health, education & living standards). HDI is inversely proportional to development. The Internet Users variable was used as a proxy for globalization and the Homicide Rate variable was used as a proxy for security. Spearman's rank correlation coefficient was computed to assess the correlation between the Perceived Stigma and the 3 variables.

Results: Spearman's rank correlation coefficient between Perceived Stigma and HDI: rho = 0.500, p-value = 0.048. Spearman's rank correlation coefficient between Perceived Stigma and Internet Users: rho = - 0.509, p-value = 0.037. Spearman's rank correlation coefficient between Perceived Stigma and Homicide Rate: rho = 0.562, p-value = 0.019.

Conclusion: Improved health, education & living standards of countries, increased cultural awareness through internet, and lower crime rates may reduce the stigma perception among individuals with mental illness.